HONG KONG, Nov. 11 (UPI) -- Researchers in Hong Kong say the H5N1 bird flu virus may provoke an excessive immune reaction, explaining why it is deadly even to the young and healthy.

Laboratory tests on human cells showed that the virus caused the immune system to send proteins called cytokines to infected lung cells, a reaction that would end up damaging or destroying the tissues the immune system is meant to defend.

The tests were carried out by scientists at the University of Hong Kong, working with samples from patients who died in Vietnam. The results were published in the online medical journal Respiratory Research.

The research suggested that patients who contract bird flu may need drugs that suppress the immune response in addition to anti-viral drugs like Tamiflu. It also indicated that healthy people with strong immune systems could fare worse than others if they became infected.

The virus has killed flocks of poultry and migratory birds, particularly in Asia, in recent months, but only 124 people have been infected, through direct contact with birds. Sixty-four of them have died.

The new research may affect preparations by health officials worldwide, who fear a pandemic may occur if the virus mutates to become passed from human to human.

WASHINGTON, Nov. 11 (UPI) -- Amidst growing concern over China's ability to control outbreaks of avian influenza, a report published in the online journal Respiratory Research Friday revealed that an H5N1 pandemic may disproportionately affect the young and healthy.

Hong Kong scientists studying the virus have discovered that H5N1 attacks its host by overwhelming the immune system in a "storm" of inflammatory proteins, 10 times more than in the annual "seasonal" influenza.

The affected proteins are those responsible for regulating the immune system's response to an attack. In the case of H5N1 infection, the drastically altered balance of proteins in the immune system leads to "an uncontrolled inflammatory response in the lung" and may explain the lung inflammation so common in sufferers of bird flu.

The study suggests that the young and healthy may be more susceptible to an avian-influenza pandemic, as their immune systems put up more of a fight against the disease, leading to the "storms" outlined in the report.

British insurers are concerned that they may be unable to cope with a bird-flu pandemic, especially if it affects those between 30 and 50, as that is the demographic most likely to hold life-insurance policies.

Although British insurance companies are the first to express concerns over the financial impact of avian influenza on their industry, today's Respiratory Research report indicates it will soon be a matter of global concern.

Meanwhile:

-- New Scientist has reported that China's Liaoning province has reported three new outbreaks in the past 24 hours and that there are indications of a suspected human case in the region.

However, 121 people in Liaoning province who complained of fever have been found not to be infected with any form of avian influenza.

-- Contrary to Thursday's reports that the two birds found infected with a form of avian influenza in Kuwait were not carrying a dangerous strain of the disease, a wild flamingo was found to have suffered from the deadly, high pathogenic strain of H5N1.

The bird did not die of bird flu but was destroyed by Kuwaiti authorities.

-- An 18-month-old Bangkok toddler has been confirmed as Thailand's 21st case of avian influenza.

The boy was taken to hospital as soon as he displayed flu-like symptoms and is said to be recovering.

-- Also in Thailand, newly appointed Public Health Minister Pinij Jarusombat spoke out against bird-flu cover-ups and said that any public official found guilty of such an attempt would face severe penalties.

Under the new policies, in place since Nov. 4, doctors found guilty of falsifying patient information with regard to avian influenza would be charged with breach of conduct and considered in breach of medical ethics.

The minister was responding to earlier charges by the Senate Public Health Commission that coverups had taken place in Thailand.

-- Rockeby, a Singaporean company, has launched 10-minute bird-flu testing kits, it was announced Friday.

Although the World Health Organization does not currently endorse any tests for avian influenza, it plans to standardize international testing for the disease.

An American test mentioned in Wednesday's Fluwrap will be released through the WHO in January. When asked about the Rockeby test, WHO officials declined to comment.

(Cytokine Storm:) Of course, flu vaccines are usually effective at preventing the flu during its peak season. But they are no guarantee, especially when flu strains mutate after the vaccine has been manufactured. Therefore, researchers are pursuing other methods of preventing the Cytokine storm by bioengineering a drug that could slow the snowball effect of antibodies. They hope to force the cytokines to recirculate in the bloodstream, rather than pool in the lungs. Experts predict that a major influenza pandemic could kill millions of people worldwide as it has done in centuries past.

Evidently, a reliable anti-cytokine treatment is not here, but efforts are being focused towards that end.

Excerpt: The new drug, an OX40 fusion protein called OX40:Ig, works by binding to the OX40 receptor and blocking activated T-cells. OX40:Ig, supplied by the company Xenova Research, stopped the symptoms of flu in mice.

China reported two new bird flu cases yesterday, including one in a province that has already suffered three outbreaks. Reports of the new outbreaks coincided with suggestions that counterfeit flu vaccines being sold in the province could be worsening the public health threat.

The latest incidents brought the total number of cases reported by China in the recent scare to eight. The outbreaks occurred in Liaoning province and Jingshan county. China has not reported any human infections in this round of outbreaks, but experts say that one is inevitable with so many cases reported in poultry.

In Thailand, a toddler became the 21st Thai to become infected with the disease.

"We have shown that RV [resveratrol], a natural polyphenol whose concentration in red wine is 1.5-3.0 mg/L, can inhibit the in vitro and in vivo replication of influenza A virus without producing any significant toxicity," the article states.

I forget where I saw it now, but a couple of days ago, I read that we have one thing in our favor so far on this thread. The worst pandemics, in terms of total number of humans killed, kill only perhaps 20% of its victims. Viruses that kill 50% to 80% (as H5N1 is doing, in its isolated cases so far) are less dangerous to humankind, because they kill too many, limiting its spread.

So the good news is, if this does mutate into virus causing a world wide pandemic, it will be less lethal, with perhaps at least 80% of those of us afflicted surviving.

"Viruses that kill 50% to 80% (as H5N1 is doing, in its isolated cases so far) are less dangerous to humankind, because they kill too many, limiting its spread."

I saw a program the other night on the National Geographic Channel (I think) titled, The Plague. One of the researchers on there said that the 'Black Death' deaths had been underestimated and it was probably over 50%. That program was followed by another titled: The Next Plague, see them if you get the chance. It covers the next pandemic which is assumed to be the mutated (human - human) H5N1. (It was scary)

But wasn't the plague spread by fleas on rats or some such, which would mean that the mechanisms that suppress the extent of epidemics caused by overly aggressive viruses spread by human to human contact would not apply?

My Mother's Mom was only 18 when she died in 1918 around the Pittsburg area. My Mother was just 9 months old and didn't get sick. Thank God.

"It struck in the Pittsburgh area in October and November of 1918 and claimed 4,500 lives. Some 22,000 cases were recorded.

In October 1918, new cases were reported in the hundreds daily and deaths numbered 175 per day. The epidemic surged to a peak around the end of October and then, gradually, the number of cases began to fall.

No one at the time knew that a virus caused influenza. Sadly, in Pittsburgh, 700 children became orphans as a result of the epidemic.

This is a rather poorly-written article. Immune cells secrete cytokines as a part of any immunological response, so the article fails to explain exactly what may set H5N1 apart from most pathogens in its stimulation of the immune system. Hyperstimulation of the immune system is one thing, but this piece makes it sound like something that happens with every inflammatory response is out of the ordinary.

I wonder if we'll now see folks make a run on corticosteroids at online "pharmacies."

The purpose of the FluWiki is to help local communities prepare for and perhaps cope with a possible influenza pandemic. This is a task previously ceded to local, state and national governmental public health agencies. Our goal is to be:

a reliable source of information, as neutral as possible, about important facts useful for a public health approach to pandemic influenza

a venue for anticipating the vast range of problems that may arise if a pandemic does occur

a venue for thinking about implementable solutions to foreseeable problems

"But wasn't the plague spread by fleas on rats or some such, which would mean that the mechanisms that suppress the extent of epidemics caused by overly aggressive viruses spread by human to human contact would not apply?"

Yup. Rats/fleas. One of the researchers speculated that two things (two infectious agents) may have been going on at the same time.

I think it might have been Judith Anne who first pointed out (on the Flu Preps thread) that Haldol (haloperidol) can be effectively used against cytokine storms. It, however, normally is used as a potent psychiatric drug and caution would be required in its use. A patient undergoing a cytokine storm might be deteriorating quickly and unable to take any oral drug. Therefore this would probably be a hospital/IM administration although JA suggested it would be worth a little research to see if a suppository form is available.

During an earlier stage of the flu, it might be worth taking a natural agent like curcumin that is known to possess the anti-cytokine activity. But curcumin must be taken along with piperine, or it is not absorbed adequately in the GI. There is at least one product on the market that combines the two. If you buy a curcumin extract make sure it carries a standardized percentage of curcumin in the 90s. Spice/tumeric has only a tiny bit of curcumin compared to the standardized extracts.

My own strategy is to boost the immune system before the influenza is contracted, to try to avoid it in the first place. Black Elderberry extract is a good way to do this. But I would stop the immune boosters immediately if there is any chance the flu has gotten a foothold. The timing of this is going to be a tricky thing because some people in 1918 died the same day they became aware they were ill with the flu.

Someone mentioned resveratrol extract -- this is good also. Again, Pinot Noir products, although more fun, have only a small amount compared to the extract. Again there is concern that resveratrol in either form may not be absorbed properly, like curcumin.

People thinking of taking turmeric (curcumin) for it's excellent antiviral effects should remember that it stimulates bile production, and so could be dangerous for someone with gall stones. Turmeric is also a potent blood thinner. People taking coumadin should check with their doctors before using turmeric.

Cinnamon also has antiviral and antibiotic effects, but should not be used by anyone taking medication for diabetes, because cinnamon definitely lowers blood sugar. Taking cinnamon in 500 mg capsules could interact with the antidiabetic medication.

Honey and fresh garlic mixed can be taken to coat the throat and have a protective antiviral effect. I don't know of any side effects, unless you are diabetic, and then you should not take it.

Yes, I agree that anyone should read about the side effects of these products. For example, the black pepper extract piperine greatly increases the absorption of some prescription drugs, as well. Could result in a dangerously elevated serum level.

The http://bird-flu-influenza.com site I just linked above recommends against using Elder berries, saying they increase, not decrease cytokines, as do many of the anti-viral herbs usually recommended for the flu.

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